Fri Mar 22 2024

110 articles - From Friday Mar 15 2024 to Friday Mar 22 2024

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Guidelines

Guidelines and related publications, position statements, white papers, technical reviews, consensus statements, etc…

Am J Gastroenterol

Assessment of the 2021 AASLD Practice Guidance for Albumin Infusion in Elective Therapeutic Paracentesis: A Regression Discontinuity Design.

Our RD models supported the 2021 AASLD Guidance with robust estimation of causal effect sizes at the cutoff level of 5 liters. Nevertheless, the findings also highlight the need to further evaluate the efficacy of albumin infusion in patients who undergo elective TP and have 3-5 liters of ascites removed.

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Endoscopy

Comparative Evaluation of a Language Model and Human Specialists in the Application of ECCO Guidelines for the Management of Inflammatory Bowel Diseases and Malignancies.

This study highlights the potential of language models in enhancing guideline adherence regarding colorectal dysplasia in IBD. Further investigation of additional resources and prospective evaluation in real-world settings are warranted.

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Hepatology

AASLD Practice Guideline on blood-based non-invasive liver disease assessments of hepatic fibrosis and steatosis.

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AASLD Practice Guideline on imaging-based non-invasive liver disease assessments of hepatic fibrosis and steatosis.

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AASLD Practice Guideline on non-invasive liver disease assessments of portal hypertension.

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Meta-analysis

meta-analyses and systematic reviews

Aliment Pharmacol Ther

Meta-analysis: Incidence of cirrhosis and hepatocellular carcinoma in patients with Fontan palliation.

The incidence of cirrhosis and HCC increases over time, especially at ≥20 years post Fontan surgery. Studies are needed to further identify at-risk patients in order to streamline surveillance for these highly morbid conditions.

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Endoscopy

Cold endoscopic mucosal resection versus cold snare polypectomy for colorectal lesions: a systematic review and meta-analysis of randomized controlled trials.

The findings of this meta-analysis suggest that C-EMR has similar efficacy and safety to CSP, but significantly increases the procedure time. Prospero CRD42023439605.

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Gastroenterology

Efficacy of Drugs Acting on Histamine-1 Receptors in Irritable Bowel Syndrome: Systematic Review and Meta-analysis.

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Relative Efficacies of Interventions to Improve the Quality of Screening-related Colonoscopy: A Systematic Review and Network Meta-analysis of Randomized Controlled Trials.

Several interventions are effective in improving adenoma detection and overall colonoscopy quality, many of which are cost-free. These results can inform endoscopists, unit managers, and endoscopy societies on relative efficacies.

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Hepatology

Accuracy of blood-based biomarkers for staging liver fibrosis in chronic liver disease: A systematic review supporting the AASLD Practice Guideline.

Blood-based biomarkers are associated with small-to-moderate change in pre-test probability for diagnosing F2-4, F3-4, and F4 in viral hepatitis, HIV-HCV co-infection, and NAFLD, with limited comparative or combination studies for other CLD.

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Imaging-based non-invasive liver disease assessment for staging liver fibrosis in chronic liver disease: A systematic review supporting the AASLD Practice Guideline.

LSM from TE, SWE, and MRE show acceptable to outstanding accuracy for the detection of liver fibrosis across various liver disease etiologies. Accuracy increased from F2-4 to F3-4 and was the highest for F4. Further research is needed to better standardize the use of imaging-based NILDA, particularly in pediatric liver diseases.

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Non-invasive liver disease assessment to identify portal hypertension: A systematic review supporting the AASLD Practice Guideline.

While imaging-based NILDA appeared to have higher accuracy than blood-based tests to detect CSPH, only 9 studies fit the a priori established inclusion criteria for the SR. In addition, there was substantial study heterogeneity and variation in cutoffs for LSM to detect CSPH, limiting the ability to establish definitive cutoffs to detect CSPH.

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Original articles

RCT, clinical trials, retrospective studies, etc…

Aliment Pharmacol Ther

Efficacy and safety of filgotinib for ulcerative colitis: A real-world multicenter retrospective study in Japan.

Real-world data demonstrate favourable clinical and safety outcomes of filgotinib for UC.

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Poor accuracy and sustainability of the first-step FIB4 EASL pathway for stratifying steatotic liver disease risk in the general population.

The first-step FIB4 EASL CP is poorly accurate and feasible for individuals at risk of SLD in the general population. It is crucial to enhance the screening strategy with a first-step approach able to reduce unnecessary VCTEs and optimise their yield.

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Prevalence of at-risk MASH, MetALD and alcohol-associated steatotic liver disease in the general population.

MASLD is prevalent among patients with elevated PDFF on MRI. There are different sex- and BMI-specific prevalence of different steatotic liver disorders. At-risk MASH demonstrates the most severe metabolic and inflammatory profiles. This study provides novel estimates for the at-risk MASH population that will be eligible for treatment with pharmacologic therapy when approved by regulatory authorities.

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Skeletal muscle mass increases after viral eradication with direct-acting antivirals in patients with chronic hepatitis C: A longitudinal study.

HCV eradication with DAA therapy was associated with a dynamic reduction of non-invasive markers of liver fibrosis and increased muscle mass in 62 patients with CHC who had an undetectable HCV load at 12 weeks after completion of antiviral treatment.

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Am J Gastroenterol

A MINORITY OF CHILDHOOD DISORDERS OF GUT-BRAIN INTERACTION PERSIST INTO ADULTHOOD: A RISK-FACTOR ANALYSIS.

Childhood DGBI persist into adulthood in 10-20% of patients, suggesting that management monitoring should continue into adulthood. Those diagnosed with anxiety or mood disorders in childhood should receive particular attention and prescription of NSAIDs in children should be made judiciously.

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Effectiveness Of Tofacitinib In Ulcerative Colitis Patients: A Nationwide Veterans Administration Cohort study.

In a nationwide cohort of UC patients initiating tofacitinib, effectiveness was seen in half of the elderly patients.

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Healthcare Costs of Irritable Bowel Syndrome (IBS) and IBS Subtypes in the United States.

Individuals with IBS exhibit higher healthcare utilization and incur substantially higher all-cause costs than those without. Care costs differ by IBS subtype.

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Limited sustained remission after nucleos(t)ide analogue withdrawal: Results from a large, global, multi-ethnic cohort of patients with chronic hepatitis B (RETRACT-B study).

Despite allowing for HBV DNA and ALT fluctuations within the first 12 months off-treatment, most patients without HBsAg loss did not maintain a sustained response thereafter. The best candidates for NA withdrawal are patients with low HBsAg levels at NA cessation, and those without profound or recurrent virological and biochemical relapses in the first off-treatment year.

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Non-Hispanic Black persons with nonalcoholic fatty liver disease have lower rates of advanced fibrosis, cirrhosis, and liver-related events even after controlling for clinical risk factors and PNPLA3 genotype.

The risk of advanced fibrosis in NHB with NAFLD is significantly lower, after controlling for clinical risk factors and PNPLA3 genotype. Although their risk for advanced fibrosis was low, NHB with NAFLD and advanced fibrosis had higher NAS and lobular inflammation, indicating a difference in their relationship between necroinflammation and fibrosis.

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Outcomes after Fecal Microbiota Transplantation in combination with Bezlotoxumab for Inflammatory Bowel Disease and Recurrent C . difficile Infection.

Overall, 5 participants (8%) experienced a CDI recurrence; 4 in the treatment arm, 1 in placebo (13% vs 3%, p=0.15). There was no clear benefit to the combination approach compared to FMT alone.

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Spleen Stiffness-Based Algorithms Are Superior to Baveno VI Criteria to Rule Out Varices Needing Treatment in Patients With Advanced Chronic Liver Disease.

Spleen stiffness-based algorithms are superior to Baveno VI criteria in ruling out VNT in patients with ACLD and double the number of patients avoiding screening endoscopy.

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Clin Gastroenterol Hepatol

Algorithm Training and Testing for a Non-Endoscopic Barrett's Esophagus Detection Test in Prospective Multicenter Cohorts.

A locked 3-MDM panel algorithm for BE/EAC detection using a non-endoscopic CCD demonstrated excellent sensitivity for high risk BE cases in independent validation samples. (Clinical trials.gov NCT02560623, NCT03060642).

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Risk of Cancer in Patients with Diverticular Disease: A Population-based Cohort Study.

Our findings show an increased long-term relative risk of cancer following a diagnosis of DD. These findings are likely due to prevalence of numerous risk factors in DD patients that confer an increased risk of cancer. The decreased relative risk of colorectal cancer might be explained by an increased likelihood of DD patients undergoing colonoscopy with polypectomy.

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Upadacitinib Achieves Clinical and Endoscopic Outcomes in Crohn's Disease Regardless of Prior Biologic Exposure.

Upadacitinib led to higher absolutes rates of clinical and endoscopic outcomes in patients without vs with prior biologic failure. Patients treated with upadacitinib achieved greater rates of clinical and endoscopic improvements vs placebo, regardless of prior biologic exposure. Clinicaltrials GOV NCT03345849, NCT03345836, NCT03345823.

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Upadacitinib Reduces Crohn's Disease Symptoms Within the First Week of Induction Therapy.

UPA45 provided rapid relief of clinical symptoms within the first week of treatment in patients with CD. Clinicaltrials Gov numbers NCT03345849, NCT03345836, and NCT03345823.

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Vedolizumab and ustekinumab levels in pregnant women with inflammatory bowel disease and infants exposed in-utero.

Maternal vedolizumab levels decrease, while ustekinumab levels remain stable over the course of pregnancy. Most vedolizumab and approximately half of ustekinumab exposed infants had undetectable drug levels by 15 weeks of age. No concerning maternal or infant safety signals were identified.

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Endosc Int Open

Artificial intelligence for characterization of colorectal polyps: Prospective multicenter study.

The CAD EYE system shows promise for detecting and characterizing colorectal polyps. Larger studies are needed, however, to confirm these findings.

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Can an educational video improve the adequacy of bowel preparation for patients undergoing their first colonoscopy? Results of the EBOPS RCT.

An educational video leads to improved bowel preparation for patients attending for their first colonoscopy, and is also associated with greater detection of polyps. Widespread adoption of an educational video incurs minimal investment, but would reduce the number of inadequate procedures, missed pathology, and the cost that both these incur.

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Can single-use versus standard duodenoscope improve ergonomics in ERCP? A comparative, simulation-based pilot study.

Our study showed that a lighter scope has a promising effect in reducing upper arm muscle activity during ERCP with potential benefit on musculoskeletal health in the ERCP setting.

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Gel immersion endoscopic mucosal resection for early gastric neoplasms: a multicenter case series study.

In conclusion, GI-EMR may be a safe and effective treatment for early, small gastric neoplasms. However, due to the small sample in the present study, further investigation is required regarding the indication for this technique.

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Performance of a single-use gastroscope for esophagogastroduodenoscopy: Prospective evaluation.

Single-use gastroscopes exhibited a high EGD completion rate and effectiveness for various indications. Further research should focus on evaluating the implementation of single-use gastroscopes in a comprehensive context, considering clinical effectiveness, costs, and environmental impact.

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Plastic versus metal stents for transmural drainage of walled-off necrosis with significant solid debris: a randomized controlled trial.

Plastic stents are not inferior to metal stents for WON drainage with significant solid debris. However, larger sample-size studies are needed to make definite conclusions.

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Upper gastrointestinal endoscopy procedure volume trends, perioperative mortality, and malpractice claims: Population-based analysis.

Also, while the 30-day mortality rate declined over the study period, it is an unsuitable quality metric for EGDs in comprehensive centers because a patient's underlying disease plays a larger role than the procedure in perioperative mortality. Finally, there were few malpractice claims, with self-evident causes prevailing.

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Water exchange technique improves colonoscopy in patients with spinal cord injury: Results of a matched cohort study.

The WE in SCI patients is feasible and safe and has the potential to improve the quality of colonoscopies substantially.

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Endoscopy

Digestive neo-epithelialization after endoscopic stenting for upper digestive tract complete disunion.

This case series shows that complete digestive rupture could be, in selected cases, successfully treated by endoscopy, adding proof-of-concept data regarding guided tissue regeneration alongside SEMS.

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Gastroenterology

Amphiregulin switches progenitor cell fate for lineage commitment during gastric mucosal regeneration.

These data demonstrate that different EGF receptor ligands can distinctly regulate isthmic progenitor-driven mucosal regeneration and lineage commitment.

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Comprehensive association analyses of extraintestinal manifestations in inflammatory bowel disease.

We have identified demographic, clinical and genetic associations with EIMs that reveal underlying mechanisms and implicate novel and existing drug targets important steps towards more personalized approach to IBD management.

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MAF-5 PREDICTS LIVER FIBROSIS RISK AND OUTCOME IN THE GENERAL POPULATION WITH METABOLIC DYSFUNCTION.

The MAF-5 score is a validated, age-independent, inexpensive referral tool to identify individuals at high risk of liver fibrosis and all-cause mortality in primary care populations, using simple variables.

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Risk of esophageal adenocarcinoma after Helicobacter pylori eradication treatment in a population-based multinational cohort study.

This absence on an increased risk of esophageal adenocarcinoma after eradication treatment of Helicobacter pylori suggests eradication is safe from a cancer perspective.

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Targeting ESE3/EHF with Nifurtimox inhibits CXCR2+ neutrophil infiltration and overcomes pancreatic cancer resistance to chemotherapy and immunotherapy.

The study demonstrated the role of EHF in the recruitment of CXCR2+neutrophils and the promising role of Nifurtimox in sensitizing pancreatic cancer to chemotherapy and immunotherapy.

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Three-dimensional imaging of the enteric nervous system in human pediatric colon reveals new features of Hirschsprung disease.

Tissue clearing and 3-dimensional imaging provides more reliable information about ENS structure than tissue sections. ENS structure changes during childhood. 3-dimensional ENS anatomy may provide new insight into human bowel motility disorders, including Hirschsprung disease.

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Gastrointest Endosc

Efficacy of the traction method in gastric endoscopic submucosal dissection: A randomized controlled trial.

Traction-assisted ESD for lesions in the lesser curvature of the upper or middle stomach were shorter, thereby reducing the procedure time of conventional ESD.

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Mobile Health technology in pediatric esophagogastroduodenoscopy quality indicators assessment: results from a national program of the Italian Society of Pediatric Gastroenterology, Hepatology and Nutrition.

Pediatric UEP practices in Italy adhere well to established quality standards. Emphasizing the adoption of disease-specific guidelines is crucial for optimizing resources, enhancing diagnostic accuracy, and minimizing unnecessary procedures. Prioritizing patient satisfaction is important for immediate enhancements in practice as well as for future research endeavors.

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Risk factors and treatment strategies for cholecystitis after metallic stent placement due to malignant biliary obstruction: a multicenter retrospective study.

The incidences of cholecystitis after SEMS placement for DMBO and HMBO were comparable. EUS-GBD is the optimal treatment option for patients with cholecystitis after SEMS placement for MBO.

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Gut

New entity of adult ultra-short coeliac disease: the first international cohort and case-control study.

Interpretation Patients with USCD are younger, have a similar symptomatic burden and benefit from a GFD. This study endorses the recommendation of D1 sampling as part of the endoscopic coeliac disease diagnostic workup.

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Hepatology

MASH clinical trials and drugs pipeline: An impending Tsunami.

In this review, we discuss the forefront of MASH drug research as of 2023/2024, illuminating mechanisms, outcomes, and future trajectories. Furthermore, we tackle the challenges confronting MASH trials and propose potential strategies for surmounting them.

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Primary biliary cholangitis drug evaluation and regulatory approval: Where do we go from here?

A recently published EMA Reflection Paper provides some guidance on the regulatory pathway to full approval but fails to recognise the importance of Real-World Data in providing evidence of outcomes benefit in rare diseases. Here we explore the impact of the EMA reflection paper on PBC therapy and offer pragmatic solutions for generating evidence of long-term outcomes through Real World data collection.

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J Hepatol

FASN-mediated fatty acid biosynthesis remodels immune environment in Clonorchis sinensis infection-related intrahepatic cholangiocarcinoma.

We uncover the metabolic signature and immune microenvironment of C. sinensis-infected ICCs and highlight the combination of FASN inhibitors with immunotherapy as a promising strategy for treating C. sinensis-infected ICCs. Impact and implications C. sinensis-infected ICC patients have a poorer prognosis and worse response to immunotherapy than non-C. sinensis-infected ICCs. The underlying molecular characteristics of C. sinensis-infected ICCs remains unclear. Herein, we demonstrate that up-regulation of FASN and free fatty acids in C. sinensis-infected ICCs leads to immunosuppressive microenvironment formation and tumor progression. Thus, administration of FASN inhibitors could significantly reverse immunosuppressive environment and further enhance anti-PD-1 efficacy in combating C. sinensis-infected ICCs.

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Phenotypes and ontogeny of senescent hepatic stellate cells in metabolic dysfunction-associated steatotic liver disease.

These data define features of HSC senescence in human and murine MASLD, establishing an important blueprint to target these cells as part of future antifibrotic therapy.

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Reviews&Editorials

Plenty of the editorials are available as full text through the publisher website using the provided link

Aliment Pharmacol Ther

Review article: New developments in biomarkers and clinical drug development in alpha-1 antitrypsin deficiency-related liver disease.

This inaugural forum generated a list of recommendations to address unmet needs in the field of AATLD.

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J Hepatol

Targeting IL-1 in severe alcohol-related hepatitis: How many frogs will we need to kiss to find an effective therapy?

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Unraveling the liver antiviral immunity in functional cure of chronic hepatitis B using scRNASeq.

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Miscellaneous

misc publications eg case reports, tools of the trade, images of the month, etc…

Am J Gastroenterol

A Case of Dysphagia Megalatriensis.

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A superficial spreading type of early gastric cancer arising in autoimmune gastritis.

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An Unusual Case of Small Intestinal Hemorrhage.

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Electronic coding for abnormal fecal immunochemical test is associated with increased colonoscopy completion.

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Navigating the Complex Landscape of Dietary Elimination Therapy in Eosinophilic Esophagitis: Can We Personalize It?

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Pharyngeal Anomaly - As Rare as We Thought?

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Response to Du et al.

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Stigma, Bias, and the Shortfalls of Body Mass Index: A reflection on the state of weight management.

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Stump appendicitis due to retained fecalith: successfully removed with ERAT.

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Clin Gastroenterol Hepatol

Endometriosis is Associated with Higher Healthcare Utilization and Upper Gastrointestinal Symptoms.

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Esophageal Enigma: Isolated Lower Esophageal Sphincter Amyloidosis.

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Validation of the THCC-RI predictive model for hepatocellular carcinoma in Asian cohort.

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Endoscopy

A modified endoscopic full-thickness resection technique: double traction-assisted resection.

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Endoscopic submucosal dissection combined with endoscopic hand suturing for a laterally spreading tumor spanning the anastomosis after radical resection of a rectal carcinoma.

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Endoscopic submucosal dissection for treatment of esophageal leukoplakia reveals hidden histopathology.

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Endoscopic ultrasound-guided embolization of a gastric varix by injection of RADA16 self-assembling peptide and coils.

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Endoscopic ultrasound-guided pancreatic duct drainage with a two-step puncture technique for a non-dilated pancreatic duct.

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Endoscopic vacuum therapy as a salvage treatment of a life-threatening esophageal perforation.

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Innovative double suturing technique for gastric endoscopic hand suturing after endoscopic submucosal dissection: a case report and technique description.

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Knife-assisted incision for restoring esophageal lumen after surgical exclusion.

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Novel technique of additional anchor plastic stent placement during endoscopic ultrasound-guided gallbladder drainage.

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Pyloric-directed therapy for gastroparesis: to cut or to relax?

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Rare case of early squamous cell carcinoma extending from the cardia to the fundus cured by endoscopic submucosal dissection.

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Recalcitrant rectal stricture following circumferential endoscopic mucosal resection: novel application of endoscopic stricturotomy.

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Simulated lateral tunneling for treating a huge submucosal tumor at the cervical esophagus.

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Successful cholangioscopy-guided biopsy using a novel thin cholangioscope under balloon enteroscopy in a patient with Roux-en-Y gastrectomy.

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Successful underwater endoscopic submucosal dissection with gel immersion for early gastric cancer in an upside-down stomach.

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Three-dimensional printing-assisted interventional therapy for thoracogastric right main bronchial fistula.

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Transpapillary biliary drainage using a forward-viewing endoscope for distal malignant biliary obstruction after placement of a duodenal stent for type I duodenal stenosis.

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Treatment of refractory esophageal stenosis after endoscopic submucosal dissection with magnetic compression anastomosis.

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Underwater endoscopic submucosal dissection performed under general anesthesia for the safe resection of superficial esophageal squamous cell carcinoma with ductal involvement.

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Use of a self-assembling peptide to control complications associated with endoscopic balloon dilation of refractory anastomotic stricture.

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Gastroenterology

Novel multimodal database for metabolic dysfunction-associated steatotic liver disease - linking genes to outcomes.

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Gastrointest Endosc

A Hairy Pedunculated Polypoid Lesion of Sigmoid Colon in a Female with Abdominal Pain and Diarrhea.

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From palliative care to a definite cure: a severe presentation of Whipple Disease.

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Stent migration after Endoscopic Retrograde Appendicitis Therapy.

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The snare-based pre-traction method facilitating endoscopic full-thickness resection of a bidirectional prominent dumbbell-shaped gastrointestinal stromal tumor in gastric fundus.

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Gut

Glucagon-like peptide-1 receptor agonists to treat chronic liver disease: real-world evidence or ambiguity?

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Hepatology

April 2024 Hepatology Highlights.

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Finding the TRAIL to escape granzyme B-mediated liver injury in PSC.

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Tranexamic acid in variceal bleeding revisited.

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J Hepatol

From the Editor's Desk...

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Hepatomegaly in a patient with a history of acute myeloid leukemia.

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Letters&Replies

Letters to the editors and authors’ replies

Clin Gastroenterol Hepatol

Severe Fatigue in Inflammatory Bowel Disease: Dopaminergic Therapy with Modanfinil or Vitamin Therapy with Thiamine.

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Gastroenterology

Comments on "Global Prevalence of Helicobacter pylori Infection and Incidence of Gastric Cancer Between 1980 and 2022".

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Disparities in Gastric Cancer Screening: A Comparative Analysis of Japan and South Korea.

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Helicobacter pylori Therapy and Risk of Gastric Cancer After Endoscopic Resection of Dysplasia: A Sensitivity Analysis Assessing Impact of Unmeasured Confounding.

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Machines advancing: marginalization of human beings on the horizon?

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Gastrointest Endosc

Different cancers in the same basket: intraductal papillary mucinous neoplasm-derived versus concomitant pancreatic carcinomas.

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Harnessing all endoscopic techniques for the management of peptic ulcer bleeding.

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Oblique fiber preservation in the prevention of GERD after peroral endoscopic myotomy.

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Propensity score matching is needed to evaluate the clinical success rate of peroral endoscopic myotomy.

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Gut

Genetic evidence for repurposing of glucagon-like peptide-1 receptor agonists to prevent chronic liver diseases.

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Smoking-related Lactobacillus and immune cell infiltration in colorectal cancer: evidence from a population-based study.

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J Hepatol

Expanding the Dialogue: A Closer Look at AIH Management and HCC Risk.

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Letter to the Editor: The MAFLD and MASLD Conundrum: Is It Reinvention Of The Wheel?

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